Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Breast Cancer Research
Published in: Breast Cancer Research 1/2016

Open Access 01-12-2016 | Research article

High mammographic breast density predicts locoregional recurrence after modified radical mastectomy for invasive breast cancer: a case-control study

Authors: Yu-Sen Huang, Jenny Ling-Yu Chen, Chiun-Sheng Huang, Sung-Hsin Kuo, Fu-Shan Jaw, Yao-Hui Tseng, Wei-Chun Ko, Yeun-Chung Chang

Published in: Breast Cancer Research | Issue 1/2016

Login to get access

Abstract

Background

We aimed to evaluate the influence of mammographic breast density at diagnosis on the risk of cancer recurrence and survival outcomes in patients with invasive breast cancer after modified radical mastectomy.

Methods

This case-control study included 121 case-control pairs of women diagnosed with invasive breast cancer between 2004 and 2009, and who had undergone modified radical mastectomy and had mammographic breast density measured before or at diagnosis. Women with known locoregional recurrence or distant metastasis were matched by pathological disease stage, age, and year of diagnosis to women without recurrence. Locoregional recurrence was defined as recurrence in the ipsilateral chest wall, or axillary, internal mammary, or supraclavicular nodes. The median follow-up duration was 84.0 months for case patients and 92.9 months for control patients.

Results

Patients with heterogeneously dense (50–75% density) and extremely dense (>75% density) breasts had an increased risk of locoregional recurrence (hazard ratios 3.1 and 5.7, 95% confidence intervals 1.1–9.8 and 1.2–34.9, p = 0.043 and 0.048, respectively) than did women with less dense breasts. Positive margins after surgery also increased the risk of locoregional recurrence (hazard ratio 3.3, 95% confidence interval 1.3–8.3, p = 0.010). Multivariate analysis that included dense breasts (>50% density), positive margin, no adjuvant radiotherapy, and no adjuvant chemotherapy revealed that dense breasts were significant factors for predicting locoregional recurrence risk (hazard ratio 3.6, 95% confidence interval 1.2–11.1, p = 0.025).

Conclusions

Our results demonstrate that dense breast tissue (>50% density) increased the risk of locoregional recurrence after modified radical mastectomy in patients with invasive breast cancer. Additional prospective studies are necessary to validate these findings.

Trial registration

The study is retrospectively registered with ClinicalTrials.gov, number NCT02771665, on May 11, 2016.
Literature
1.
Jemal A, Center MM, DeSantis C, Ward EM. Global patterns of cancer incidence and mortality rates and trends. Cancer Epidemiol Biomarkers Prev. 2010;19(8):1893–907.CrossRefPubMed
2.
Boyd NF, Guo H, Martin LJ, Sun L, Stone J, Fishell E, Jong RA, Hislop G, Chiarelli A, Minkin S, et al. Mammographic density and the risk and detection of breast cancer. N Engl J Med. 2007;356(3):227–36.CrossRefPubMed
3.
McCormack VA, dos Santos Silva I. Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2006;15(6):1159–69.CrossRefPubMed
4.
Eriksson L, Czene K, Rosenberg L, Humphreys K, Hall P. Possible influence of mammographic density on local and locoregional recurrence of breast cancer. Breast Cancer Res. 2013;15(4):R56.CrossRefPubMedPubMedCentral
5.
Park CC, Rembert J, Chew K, Moore D, Kerlikowske K. High mammographic breast density is independent predictor of local but not distant recurrence after lumpectomy and radiotherapy for invasive breast cancer. Int J Radiat Oncol Biol Phys. 2009;73(1):75–9.CrossRefPubMed
6.
Cil T, Fishell E, Hanna W, Sun P, Rawlinson E, Narod SA, McCready DR. Mammographic density and the risk of breast cancer recurrence after breast-conserving surgery. Cancer. 2009;115(24):5780–7.CrossRefPubMed
7.
Allred DC, Medina D. The relevance of mouse models to understanding the development and progression of human breast cancer. J Mammary Gland Biol Neoplasia. 2008;13(3):279–88.CrossRefPubMed
8.
Alowami S, Troup S, Al-Haddad S, Kirkpatrick I, Watson PH. Mammographic density is related to stroma and stromal proteoglycan expression. Breast Cancer Res. 2003;5(5):R129–35.CrossRefPubMedPubMedCentral
9.
Hawes D, Downey S, Pearce CL, Bartow S, Wan P, Pike MC, Wu AH. Dense breast stromal tissue shows greatly increased concentration of breast epithelium but no increase in its proliferative activity. Breast Cancer Res. 2006;8(2):R24.CrossRefPubMedPubMedCentral
10.
Lahlou H, Muller WJ. Beta1-integrins signaling and mammary tumor progression in transgenic mouse models: implications for human breast cancer. Breast Cancer Res. 2011;13(6):229.CrossRefPubMedPubMedCentral
11.
van Dongen JA, Voogd AC, Fentiman IS, Legrand C, Sylvester RJ, Tong D, van der Schueren E, Helle PA, van Zijl K, Bartelink H. Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial. J Natl Cancer Inst. 2000;92(14):1143–50.CrossRefPubMed
12.
Poggi MM, Danforth DN, Sciuto LC, Smith SL, Steinberg SM, Liewehr DJ, Menard C, Lippman ME, Lichter AS, Altemus RM. Eighteen-year results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy: the National Cancer Institute Randomized Trial. Cancer. 2003;98(4):697–702.CrossRefPubMed
13.
Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, Jeong JH, Wolmark N. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347(16):1233–41.CrossRefPubMed
14.
Aapro MS, Forbes JF. Three years' follow-up from the ATAC trial is sufficient to change clinical practice: a debate. Breast Cancer Res Treat. 2003;80 Suppl 1:S3–11. discussion S13-18.CrossRefPubMed
15.
16.
Wang J, Chang KJ, Kuo WH, Lee HT, Shih TT. Efficacy of mammographic evaluation of breast cancer in women less than 40 years of age: experience from a single medical center in Taiwan. J Formos Med Assoc. 2007;106(9):736–47.CrossRefPubMed
17.
Sovio U, Li J, Aitken Z, Humphreys K, Czene K, Moss S, Hall P, McCormack V, dos-Santos-Silva I. Comparison of fully and semi-automated area-based methods for measuring mammographic density and predicting breast cancer risk. Br J Cancer. 2014;110(7):1908–16.CrossRefPubMedPubMedCentral
18.
Sandberg ME, Li J, Hall P, Hartman M, Dos-Santos-Silva I, Humphreys K, Czene K. Change of mammographic density predicts the risk of contralateral breast cancer - a case-control study. Breast Cancer Res. 2013;15(4):R57.CrossRefPubMedPubMedCentral
19.
McGale P, Taylor C, Correa C, Cutter D, Duane F, Ewertz M, Gray R, Mannu G, Peto R, Whelan T, et al. Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials. Lancet. 2014;383(9935):2127–35.CrossRefPubMed
20.
Gierach GL, Ichikawa L, Kerlikowske K, Brinton LA, Farhat GN, Vacek PM, Weaver DL, Schairer C, Taplin SH, Sherman ME. Relationship between mammographic density and breast cancer death in the Breast Cancer Surveillance Consortium. J Natl Cancer Inst. 2012;104(16):1218–27.CrossRefPubMedPubMedCentral
21.
Lin CH, Liau JY, Lu YS, Huang CS, Lee WC, Kuo KT, Shen YC, Kuo SH, Lan C, Liu JM, et al. Molecular subtypes of breast cancer emerging in young women in Taiwan: evidence for more than just westernization as a reason for the disease in Asia. Cancer Epidemiol Biomarkers Prev. 2009;18(6):1807–14.CrossRefPubMed
22.
Yao ES, Zhang H, Chen YY, Lee B, Chew K, Moore D, Park C. Increased beta1 integrin is associated with decreased survival in invasive breast cancer. Cancer Res. 2007;67(2):659–64.CrossRefPubMed
23.
dos Santos PB, Zanetti JS, Ribeiro-Silva A, Beltrao EI. Beta 1 integrin predicts survival in breast cancer: a clinicopathological and immunohistochemical study. Diagn Pathol. 2012;7:104.CrossRefPubMedPubMedCentral
24.
Kim MY, Oskarsson T, Acharyya S, Nguyen DX, Zhang XH, Norton L, Massague J. Tumor self-seeding by circulating cancer cells. Cell. 2009;139(7):1315–26.CrossRefPubMedPubMedCentral
25.
Comen E, Norton L, Massague J. Clinical implications of cancer self-seeding. Nat Rev Clin Oncol. 2011;8(6):369–77.PubMed
26.
Chen JL, Cheng JC, Kuo SH, Chan HM, Huang YS, Chen YH. Prone breast forward intensity-modulated radiotherapy for Asian women with early left breast cancer: factors for cardiac sparing and clinical outcomes. J Radiat Res. 2013;54(5):899–908.CrossRefPubMedPubMedCentral
Metadata
Title
High mammographic breast density predicts locoregional recurrence after modified radical mastectomy for invasive breast cancer: a case-control study
Authors
Yu-Sen Huang
Jenny Ling-Yu Chen
Chiun-Sheng Huang
Sung-Hsin Kuo
Fu-Shan Jaw
Yao-Hui Tseng
Wei-Chun Ko
Yeun-Chung Chang
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Breast Cancer Research / Issue 1/2016
Electronic ISSN: 1465-542X
DOI
https://doi.org/10.1186/s13058-016-0784-3

Other articles of this Issue 1/2016

Breast Cancer Research 1/2016 Go to the issue

Research Article

Circulating insulin-like growth factor-I, insulin-like growth factor binding protein-3 and terminal duct lobular unit involution of the breast: a cross-sectional study of women with benign breast disease

Research article

Circulating cell-free DNA-based epigenetic assay can detect early breast cancer

Research article

Mammographic density and breast cancer risk: a mediation analysis

Research article

Proteomic analysis of breast tumors confirms the mRNA intrinsic molecular subtypes using different classifiers: a large-scale analysis of fresh frozen tissue samples

Review

Circadian clocks and breast cancer

Research article

Intratumoral heterogeneity as a source of discordance in breast cancer biomarker classification
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits